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CH10253A INTERNATIONAL COMMUNITY HEALTH SERVICES (Active)
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Main Details
Name
INTERNATIONAL COMMUNITY HEALTH SERVICES
Subdivision Name
ICHS - HOLLY PARK MEDICAL & DENTAL CLINIC
Type
HRSA-Funded Health Center
Site ID
BPS-H80-005436
340B ID
CH10253A
Grant Number
H80CS00437
Additional Details
Current Program Status
Active
Registration Date
12/7/2006
Participating Start Date
1/1/2007
Participating Approval Date
12/7/2006
Last Recertification Date
2/12/2025
Contacts
Authorizing Official
ICHS
Kelli Nomura, CEO
(206) 788-3659
Primary Contact
ICHS
Ju Hui Lee, Pharmacy Director
(206) 788-3756
Addresses
Street Address
3815 S OTHELLO ST
SEATTLE, WA 98118-3510
Billing Address
INTERNATIONAL COMMUNITY HEALTH SERVICES
PO BOX 3007
SEATTLE, WA 98114-3007
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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11/9/11 - Changed Contact name and info from QUYNH TRAN.
11/09/2011
May 2025
May 2025
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